Surgical instrument



May l, 1923.- 1,453,934

D. LO GIUDICE SURGICAL INSTRUMENT Filed May 3. 1921 2 Sheets-Sheet l ATTORNEYS May'l, 17923.

- 1,453,934 D. LO GIUDICE SURGI CAL INSTRUMENT WIT/VE S 2,4

A TTU/MEMS' Patented May 1, 1923.

Unirse erstes innen erica.

raranri noiifrriarczi- Lo sinnlos, or BROOKLYN, NEW YORK, Assisnoagro enormen '.rr'EMANN a COMPANY, or New Yoan, N. Y., e cORPonATrON or new YORK.

senatori! INSTRUMNT.

.application ined May s, 19,21. serial No. 466,506'.

To all whom. t may concern VBe it known that I, Dominion Lo GIU- Dioii, a subject of the King otItaly, and resident ot' the city of New York, borough of Brooklyn, county or' Kings, and State' of New York, have invented a new and Improved Surgical Instrument, Ot which the following is a full, clear, and exact description.

Hy invention relates tov a surgical instrument and aims to provide a device of this character which shall present certain improved construction over instruments ot the classl to which it relates,` now upon the 1'5 market.'

In connection with' the removing oit tonsils, it is a well appreciated fact that numerous instruments have been proposed, and utilizedwith af view of accomplishing the severance of the to'ns'ilsv from the tis sues withL which 'tjl'iey are associated.

yEntirely asidel troni'V the foregoing it vis well understood among physicians, that a danger is always present at the time ot the removal of the rtfonsils, inV that the severed tonsilI yliable to drop; into the passages extending from the mouth to the stomach and' lungs. An accident of this nature and is'lience to beguarded against withv the greatest of precauton.

Also it is well understood that severance of the tonsils ofte-n results in hemorrhages, which has sometimes proven fatal vdue tothe inaccessibility ot the tissues severed;

Having the foregoing in mind, I have inventeda surgical instrument. which shall primarily be capable ot insertion to the month of the patient with a minimum ot discomforture, as well as being capable of having its parts disassembledv with a minimum' of ease. whereby the same may be cleansed. A

A stillturther object of my invention is the? coristri'iction Iof afsurgical instrument ns of, which1theltonsil may be re'- movedlfrolr .the` 'mouth' of the" patient withi 'ffS be'lllgP/e 'l that a ,severv of device? inl a-v more' rapid manner than has been heretofore proposed.

site of' my invention is .the l .0f surgicall"ins numient. which shall ei'ect'a severance of the tissues" 1n Stich of the parts.

often results in the death ot the. patient,r

a manner that the danger ot a hemorrhage resulting will have been reduced to a mini-.

mum. I

' Further objects of my invention willivppear in thea'nnexed specification arid drawings, ,which latter present one practical embodiment ot my invention, and in' which:

Figurel 1 is a plan view ot the instrument and showing the parts of the same in their initial position.

Figure 2 is al view similar tov Figure 1 and showing the lirst stage in the Operation Figure 3 is a similar view and showing the second stage oi operation. v

. Figure 4 '1s stillanother View `and showing the parts inv their third or final. position. y Figure 5 aside view of the device as illustrated in Figure 1. Figure 6 is a sectional side View similar to Figure 5.

Figures 7, 8 and 9 are sectional views coi1`r respondingto Figure 6 and 'showing the stages illustrated in" Figures 2, '3 and 4. f

Figures 10 to 15 are perspective viewsof each of the elements which goto provide the finished instrument'and showing these yelements disassembled, and

Figure 16 is a transverse sectional view taken along the line 164-16 ot Figure 4.'

Referring' now more particularly to Fig# ures 10 to 15 it will be seen' that my. instrument preferably `comp/rises. siX units which when assembled provide the completed instrument.

The lirst unit illustrated in Figure 10 is a member which provides adjacent its outer. end a crushing blade 20,"a shank 21 forming a rearwardly extending continuation ot this blade. the rear end oi the shank being formed with longitudinally eXtending slotsi 22 for a purpose hereinafter more fully specified. AThe second unit yshown in Aigure 11: also this shank terminating ina severingblade 25 below which is arranged. af harnoon' 2.6

h avin f its Shank .l i *.V Withieterence to the elementV illustrated rear endtifedly secured to the 1 in Figure 12 it will ib e that-the`-same" each other. llt ith a view of properly retaining these latter units the base is formed adjacent its outer end with side walls 2S providing a longitudinally extending groove 29 in their side faces, which grooves are adapted to receive fins 30 positioned adjacent the side edges of both the blades and so that the latter are slidahly retained by the base. lt is also to be noted in this connection that the side walls 28 extend beyond the end of the base 27 and are preferably connected together adjacent their outer ends by means of a bridgeportion 31 which in use acts as a stop for limiting the movement of the units illustrated in Figures 10 and 11.

Further the base 27 is formed adjacent its outer end with a groove 32 capable of slidably accommodating the harpoons 26, and a longitudinally extending slot 33 in the rear end of the shank 34 of this base is adapted to underlie the longitudinal openings 22 and 24 of the units aforementioned.

With a v iew of providing means which will serve to support the element afore mentioned in a most convenient manner, and permit of their eflicient co-operation I preferably employ a handle 35 as in Figure 15, which handle provides what might be termed a pistol grip. Furthermore the upper end of this handle is constructed so as to suspend a. guide block 36 capable of slidably receiving the rear ends of each of the units shown `in Figures 10, 11 and 12` the latter unit being normally held in fixed position by any suitable means such as a plate 37 pivotally connected as at 38 adjacent the block 36 and formed with prongs 39 adapted to project into corresponding` recesses 40 forming a part of the base unit.

Finally my invention contemplates the ose of the elements shown in Figures 1R and 14 the latter being in the nature of a trigger which is pivotally supported between the lugs 42 of the handle 35, the element illustrated in Figure 13 serving' as a fulcrum member and having its shank 43 passing through the openings in the trigger 41 and lugs 42` its body 44 extending rearwardly from these openings, the arm 45 thereof passing preferably around the lugs and detachably engaging a recess 46 positioned adjacent the upper end of the handle.

lt will now be noted, referring to the unit illustrated inA Figure 10 that in addition to the aforedescribed construction, a ratchet 41T is provided. adjacent one of the side edges of the shank and inner end of the slot 22, and an outwardly extending lug 48 is formed upon the opposite side edge, a centrally positioned downwardly extending pin 49 being secured to the shank 21 ata point preferably adjacent the two last named portions.

The unit illustrated in Figure 11 has a slot 5G provided in addition to the slot 24 mnd theislot 50 forms a continuation of tac inner end of the slot 24 and is of sufficient width to accommodate the pin 49, it being also noted that a lug 51 corresponding to the lug 48 is provided and that a. spring pressed pawl 52 is pivotally secured adjacent the slot 24 and normally has its rear end eX- tending into the same.

Assuming now that the units shown in Figures 10, 11 and 12 have been superimposed, the large plate 37 having been swung outwardly and the rear ends of all ofthe units aforementioned having` been positioned in the opening provided for this purpose in the block 3G, it will be seen that the base will be retained in applied position as aforementioned by means of the prongs 39 cooperating with the recess 40 thereof, and the bridge portion 31 of the base members will in turn limit the movement of both the crushing and severing members.

Upon the trigger now having its shank 53 extended through the slots 33, 24 and 22, and having its body associated with the lugs 42 by means of the member illustrated in Figure 13 it will be appreciated that the device vwill appear yas has been shown in Figures 1, 5 and 6, assuming that the units shown iu Figures 10 and 11 have been moved to their fully retracted position.

The device may now be applied to a tonsil or other member to be removed, and it will be obvious that a pull upon the trigger 41 will primarily result in this element engaging the upper end of the slot 22 and aecordingly move the crushing blade 20, as in .Figure 2 forward to a point at which it will lie adjacent the bridging portion 31 this operation of the parts also having been illustrated in Figure 7. Y a

In this connection it will be seen that any return of the crushing blade is precluded. by virtue of the fact that they ratchet 4'? associated with the shank 21 thereof will be. engaged by a spring pressed pawl 54 'secured adjacent the upper end of the handle for this purpose. Furthermore the severing blade 25 will remain stationary for a certain length of time during the projection of the crushing blade by virtue of the fact that the' pin 49 of the shank 21 rides in the. slot 50 ot Athe shank 23. Thus lthe crushing blade will, during this stage of they operation, remain in advance of the severing blade. Upon a further movement of the crushing blade the pin 49 will reach the inner end of the'slot 50 and this will result in a synchronous traveling of fthe severing blade with the crushing blade for a certain distance. The crushing blade will now have effected a pinching off ofthe member to be. removed by. having crushed the tissues which connect it. Thus any danger of hemorrhages` will have been avoided. Tov now effect a. complete detachment of the memberthe trigger is again swung to its normal posi` ion tion as in Figures 8 and 8 from the posi-l tion shown in'Figures 2 and 7. In' thus swinging the shank 53 will pass thespring pressed pawl 52 and upon thetrigger again beingv actuated 'it will bel obvious thatrthe shank thereof will be caused to 'engage the pawl 52, which' blocks its passagethroughtheslot 24 yand thus the severing blade 25 will be projected forward to the position shown in Figures 4 and 9, and byvirtue of the'harpoon 26 it' will be` seeinv that the. thusl completely severed member is engaged by a flange which will absolutely prevent any' danger of its dropping so that a subsequent removal of the instrument. will result in a lmovement of the severed member.

In re-setting the device the pawl 54 is primarily swung so as to move out vof engage-v ment with the ratchet .47 and this will per-l mit 0f the crushing blade 20 being retracted by means of the lug 48 to its normal position'. that the pin 49 serves a double purpose in that the same will now press against the pawl 52 and swing the same inwardly to permit of a subsequent retraction ofthe sev-A by virtue of the ready disassemblage whichL is allowed by the construction specified.

rIhus I have provided a surgical instrument by means of which all of the objections enumerated in the preamble of this specification will have been avoided aside from the tact that a device thus constructed embraces a minimum of parts and is capable of being 'manufactured at a nominal ligure.

Obviously numerous modiications of structure might readily be resorted to without in the least departing from the spiritof my invention, which I claim as:

l. A surgi-cal instrument including a base, a crushing blade. a severing blade and means tor sliding the blades on the base, said means including a single lever to be manually actuated a plurality ai: times to operate the blades for a single crushing and severing Operation, controlling means for automatically causing the first actuation of the lever to project the crushing blade a `predetermined distance and thereupon to further project the crushing blade while projecting` both blades, detent means for holding the blades projected as just described while permitting a retraction of said lever, and secondary controlling means formed in part by the first mentioned controlling means `for vautomat- In this connection it is to be noted' ically causing` a `second actuation of said lever 7to move the severing `blade-relativev to the' crushing a crushing blade, a severing blade yand means for sliding the'blades on the base, said means blade to further projectthe severing blade. f 4' j j 2. A Asurgical instrument including a base,

including. a single lever to be'inanually actu- -A ated a plurality of utimes to` operate the 4 blades :tor a single crushing and severing operation, controlling means for automatically causing thefirst actuationvof .the leverto f i project the 'crushingblade a predetermined distance andv thereupon to further project thel'erusliing bladegwliile projecting ,bot-hj blades, detent means for holding the blades projected as just described while permitting' a retraction of said lever, and secondary controlling means forn'ied inpart by the first mentioned controlling means for auto-.

matically causing a second actuation 'otsaid lever to move the severing blade` relative `to the crushing lblade to further project the severing blade, both controlling meanshaving eo-acting parts, all of which are carried by the lever and thetwo blades.`

v3. Avsurgical instrument including abase, a crushing blade, a,severing'blade, and means for sliding the blades. on the case, said means including a single lever to be manually actuated a plurality of times to operate the blades for a single lcrushing and severing operation, controlling means for automatically causing the iirst actuation .of the lever to project the crushing blade a `predetermined distance and) thereupon to further project the crushing blade while projecting both blades, detent means for holding the blades projected as `just described while permitting a retraction of said lever,

and. secondary controlling means formed in `part by the first mentioned controlling means for automatically causing a second actuation of said'lever to move the severing blade relativeto-the crushing blade tofurther project the severing blade, and a harpoon carried by one of the blades, the har'- poon, the crushing blade and Ithe severing blade being always arranged inzclose overlapping relation. y i

4. A surgical instrument including a handle, a base member, a crushing and a severiiig blade slidably mounted uponsaid base member, a trigger `for projecting said blades, said basev` member, crushing blade and severing blade `bei-ng formed with slots, a shank secured to and forming a continuation. of-

said trigger, said trigger being pivotally mounted and having a shank extendingA through said slots and a. spring pressed pawl secured to said severingr blade and normally y having its outer end extending into theslot forming a part thereof. v .y

A .surgical instrument iiiicludingl a handle, a base member, a crushing andla severing bladeelidebly mounted upon said base member, a. tri gger tor projecting said blades, saidbase member, crusliingblade and severing blade being formed with slots, a shank Secured to and formingr a. continuation Of said4 trigger, said trigger-1 being piivotally mounted and having' a shank extending through Said Slots, a. springpressed. pawlse- Cured to said eevering` blade and normally having its` outer end extending into the slot forming a part thereof, and means for effecting a retrasrftion of said pawl during the re-' setting' of said parte.

G. A surgical instrument including` a handle a base member, a crushing and a severing' blade slidably mounted upon said base member, a trigger t'or projecting said blades, said base member, crushing' blade and severing blade being llornied with vslots, a shank seCuredt-o and forming a Continuation of Said trigger, said trigger being piv otally mounted and having a shank extending' through said slots, a Spring pressed paWl secured to Said severing blade and normally having its outer end extending into the slot forming` a part, thereofq and a pin secured to the under sideof said crushing blade and beine' adapted torride in afslotvfqrming a continuation of the slot of said severing blade.

,.DoMieNieK Lo emmen. 

